Excessive Sweating causes and treatment and how to stop at night, underarms, skin sweat glands, use of natural supplements, herbs
July 2 2015 by
Ray Sahelian, M.D.

Excessive sweating affects about 2% of the population and has a significant negative impact on quality of life. It affects the axillae in approximately 80% of cases. Excessive sweating results from excessive sympathetic stimulation of the eccrine sweat glands: the various treatment modalities available target points along the pathway between the central nervous system and the peripheral gland. Primary hyperhidrosis is an excessive sweating disorder with no known cause, which most commonly affects the palms, soles, underarms, face and scalp. Excessive sweating is one of the oldest known dermatologic conditions that even today is misconceived as rare and untreatable. The description and definition of excessive sweating date back to Hippocrates in the 4th century B.C.

Cause of excessive sweating
Two factors that seem to accompany this condition are family history, with 30 percent to 65 percent of patients having a family history of the condition, and the age range of the first symptoms. One part of the brain controls the sweating response to body temperature, while another area controls the sympathetic, or emotional sweating response. For reasons unclear to excessive sweating researchers, the emotional component is in overdrive. The result is typically a healthy individual who perspires excessively, even in mildly stressful situations, such as a handshake or job interview. This can have socially debilitating consequences, particularly in young adults.

Heat or stress.
Recent physical activity.
Hormonal changes.
Metabolic disorder.
Certain prescription drugs.
Certain dietary supplements and herbs such as tongkat ali, yohimbe, or ginseng.

A survey suggests that the prevalence of primary excessive sweating is 2.8 percent in the U.S. population, 1.4 percent have excessive sweating in the underarms (axillary hyperhidrosis), and one-sixth are projected to have sweating that is intolerable or interferes with daily activities. There also is a hereditary component, as approximately half of these patients have a relative with Excessive Sweating.

Nighttime excessive sweating
Excessive sweating affects people while they are awake, but nighttime sweating is never normal. A careful history and physical examination must be performed to rule out other causes of excessive sweating, which physicians call secondary hyperhidrosis. In contrast to the primary form, secondary excessive sweating is associated with other potentially serious medical problems that need further workup from physicians.

Excessive Sweating treatment
Treatment options are based on the severity and the risks and benefits of therapy. They can range from antiperspirants to surgery, which involves disconnection of the sympathetic nerves that direct sweating in the arms and hands. The first line of treatment is topical aluminium chloride, which is effective in the majority of cases. Alternative treatments such as systemic anti-cholinergics and iontophoresis have significant disadvantages, while surgical sympathectomy has been regarded as the gold-standard in treatment of this condition. Recently, attention has focused on the use of intradermal botulinum toxin for the treatment of axillary hyperhidrosis. This is a highly effective, minimally-invasive treatment with few side effects, and is now recommended as the treatment of choice in isolated axillary hyperhidrosis.

Aust Fam Physician. 2013. Hyperhidrosis and bromhidrosis -- a guide to assessment and management. Excessive sweating and bromhidrosis are two common conditions, which are troublesome for patients and carry a significant psychosocial burden. Hyperhidrosis can be either generalised or focal. Generalised sweating may be primary and idiopathic or secondary to systemic disease. Treatment may require oral anticholinergic agents. Focal sweating is usually primary and responds to topical measures. Specialist referral for botulinum toxin A, iontophoresis or sympathectomy should be considered for severe cases. Bromhidrosis usually responds to antiperspirants, fragrance and antibacterial agents.

The Food and Drug Administration approval of botulinum toxin type A (Botox) has provided a treatment of excessive sweating, particularly for the underarms. Other treatments may be utilized for excessive sweating on the face, the palms, or soles of the feet.

Practical recommendations
Stay in air conditioned rooms, drink cold water, avoid hot drinks such as coffee or tea, reduce hot soup intake, reduce emotion triggering situations, take a zen approach to life with calmness and placidity.

Avoid these herbs and supplements
Some herbs and supplements can increase body heat and lead to more sweating. The herbs include ginseng, tongkat ali, ephedra, and yohimbe. Nutrients that can increase body temperature include choline, trimethylglycine, or CDP-choline. Choline converts into acetylcholine.

There is an association between tinea pedis or interdigital mycosis and focal plantar hyperhidrosis.

Excessive sweating in women
Women with clammy handshakes are twice as likely to seek medical attention as men with sweaty palms. Researchers from the Saint Louis University School of Medicine, Missouri, studied the records of 515 patients who sought treatment for excessive sweating and found about 67 percent of those seeking help were women. Men are more likely to seek treatment for facial sweating while women were more likely to seek help for excessive underarm sweating.

Prescription medication treatment
Br J Dermatol. 2015. Oxybutynin as a treatment for generalized hyperhidrosis: a randomized, placebo-controlled trial. Hyperhidrosis is a disorder that can impair quality of life. Localized treatments may be cumbersome and ineffective, and no systemic treatments have proven to be significantly beneficial. Treatment with low-dose oxybutynin is effective in reducing symptoms of hyperhidrosis in generalized or localized forms. Side-effects were frequent but minor and mainly involved dry mouth.

Do you have any supplement pills to help with excessive sweating? Any cooling herbs for the body?
    Melatonin used at night may lower body temperature but I am not aware of herbs that reduce sweating although I am certain there are some.

Axillary Excessive Sweating is in the armpit or underarm
Palmar Excessive Sweating is of the palms